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General NPI Number Information
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NPI Number | 1861375487
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Entity Type | Organization
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Legal Business Name | RAINEY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 4104 GALLANT FOX DR
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City | COLUMBIA
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State | MO
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Zip | 65202-4531
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Country | US
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Telephone | 573-268-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 5828 E WATERS EDGE DR S
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City | COLUMBIA
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State | MO
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Zip | 65202-6540
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Country | US
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Telephone | 573-268-1510
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JOANNE ELAINE RAINEY
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Credential |
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Telephone | 573-268-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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